Information Collection

CMS-10437.GenIc#19 - Marketplace Consumer Persona Research

IC 240055 under ICR 201708-0938-025 · OMB 0938-1247.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1247 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10437.GenIC#19 CMS-10437.GenIc#19 - Marketplace Consumer Persona Research Form and Instruction
CMS-10437.GenIC#19 CMS-10437.GenIC#19. HIM pre-group workbook insured CMS-10437.GenIC#19. HIM pre-group workbook insured (final) 2-20-20.docx Form and Instruction
CMS-10437.GenIC#19 CMS-10437.GenIC#19. HIM pre-group workbook uninsured CMS-10437.GenIC#19. HIM pre-group workbook uninsured (final) 2-20-20.docx Form and Instruction
CMS-10437.GenIC#19 CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Insured (final) 2-20-20.docx Form and Instruction
CMS-10437.GenIC#19 CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Uninsured (final) 2-20-20.docx Form and Instruction
CMS-10437.GenIC#19.MarketplacePersonaSupportingStatement (final)-2-20-20.docx CMS-10437.GenIC#19.MarketplacePersonaSupportingStatement (final)-2-20-20 IC Document
CMS-10437.GenIC#19.MarketplacePersonaStudyInitiationRequest (final) 2-20-20.docx CMS-10437.GenIC#19.MarketplacePersonaSupportingStatement (final)-2-20-20 IC Document
CMS-10437.GenIC#19.Justification for Providing Incentives (final)2-20-20.docx CMS-10437.GenIC#19.Justification for Providing Incentives (final)2-20-20 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CMS-10437.GenIc#19 - Marketplace Consumer Persona Research	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10437.GenIC#19. HIM pre-group workbook insured	CMS-10437.GenIC#19. HIM pre-group workbook insured	CMS-10437.GenIC#19. HIM pre-group workbook insured (final) 2-20-20.docx	Yes	No	Printable Only
Form and Instruction	CMS-10437.GenIC#19.HIM pre-group workbook uninsure	CMS-10437.GenIC#19. HIM pre-group workbook uninsured	CMS-10437.GenIC#19. HIM pre-group workbook uninsured (final) 2-20-20.docx	Yes	No	Printable Only
Form and Instruction	CMS-10437.GenIC#19	CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Insured	CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Insured (final) 2-20-20.docx	Yes	No	Fillable Printable
Form and Instruction	CMS-10437.GenIC#19	CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Uninsured	CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Uninsured (final) 2-20-20.docx	Yes	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 160	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	160	160
Annual IC Time Burden (Hours)	400	400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
CMS-10437.GenIC#19.MarketplacePersonaSupportingStatement (final)-2-20-20	CMS-10437.GenIC#19.MarketplacePersonaSupportingStatement (final)-2-20-20.docx	02/21/2020
CMS-10437.GenIC#19.MarketplacePersonaSupportingStatement (final)-2-20-20	CMS-10437.GenIC#19.MarketplacePersonaStudyInitiationRequest (final) 2-20-20.docx	02/21/2020
CMS-10437.GenIC#19.Justification for Providing Incentives (final)2-20-20	CMS-10437.GenIC#19.Justification for Providing Incentives (final)2-20-20.docx	02/21/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.